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Nonprofiteer
← SAMARITAN MEDICAL PRACTICE PC

Form 990 for tax year 2022

Filed by SAMARITAN MEDICAL PRACTICE PC.

Totals

Total revenue
$7,036,756
Total expenses
$17,964,393
Contributions and grants received
$0
Grants paid
$0
Program service revenue
$7,036,756
Investment income
$0
Other revenue
$0
Total assets, end of year
$1,874,931
Total liabilities, end of year
$1,874,931
Net assets or fund balances, end of year
$0
Program services expenses (Part IX)
$17,948,102
Management and general expenses
$16,291
Fundraising expenses
$0
Program service expenses (Part III)
$17,948,102

Program services were 99.9% of total expenses calculated — Part IX's program-services column over total expenses, both as filed.

Line items

Every line the filer filed in Parts VIII, IX and X, as filed and in filed order. Blank columns are left out, and the lines are not forced to add up to the totals above.

Revenue

Part VIII, the statement of revenue.

  • 2a · Program service revenue: PATIENT SERVICE REVENU

    total $7,036,756 · related or exempt $7,036,756

Functional expenses

Part IX, the statement of functional expenses.

  • 7 · Other salaries and wages

    total $12,204,624 · program services $12,204,624

  • 9 · Other employee benefits

    total $1,249,685 · program services $1,249,685

  • 11c · Fees: accounting

    total $16,291 · management and general $16,291

  • 11g · Fees: other

    total $914,073 · program services $914,073

  • 13 · Office expenses

    total $58,143 · program services $58,143

  • 14 · Information technology

    total $572 · program services $572

  • 16 · Occupancy

    total $712,842 · program services $712,842

  • 17 · Travel

    total $5,612 · program services $5,612

  • 19 · Conferences, conventions and meetings

    total $29,623 · program services $29,623

  • 22 · Depreciation, depletion and amortization

    total $99,640 · program services $99,640

  • 23 · Insurance

    total $627,500 · program services $627,500

  • 24a · Other expenses: PURCHASED SUPPORT SERVI

    total $817,437 · program services $817,437

  • 24b · Other expenses: CONTRACT PHYS.

    total $748,423 · program services $748,423

  • 24c · Other expenses: PROVISION FOR BAD DEBTS

    total $283,100 · program services $283,100

  • 24d · Other expenses: MEDICAL/PHARMACY CHARGE

    total $171,704 · program services $171,704

  • 24e · All other expenses

    total $25,124 · program services $25,124

Balance sheet

Part X, book values.

  • 1 · Cash, non-interest-bearing

    beginning of year $496,678 · end of year $515,499

  • 4 · Accounts receivable

    beginning of year $624,844 · end of year $784,253

  • 9 · Prepaid expenses and deferred charges

    beginning of year $6,950 · end of year $68,844

  • 10a · Land, buildings and equipment: cost or other basis

    $1,853,133

  • 10b · Land, buildings and equipment: accumulated depreciation

    $1,531,798

  • 10c · Land, buildings and equipment, net

    beginning of year $420,974 · end of year $321,335

  • 15 · Other assets

    beginning of year $6,825,463 · end of year $185,000

  • 17 · Accounts payable and accrued expenses

    beginning of year $1,742,548 · end of year $519,854

  • 25 · Other liabilities

    beginning of year $6,632,361 · end of year $1,355,077

Mission and programs · 2022

Mission

THE MISSION OF SAMARITAN MEDICAL PRACTICE PC IS TO SUPPORT THE CHARITABLE PURPOSES OF SAMARITAN MEDICAL CENTER, INC. WHICH INCLUDES PROVIDING PHYSICIAN SERVICES DESIGNED TO IMPROVE THE STANDARDS AND QUALITY OF HEALTHCARE AVAILABLE TO THE RESIDENTS OF JEFFERSON COUNTY AND OTHER AREAS SERVED BY THE HOSPITAL. FURTHERMORE, OUR PURPOSE IS TO PARTICIPATE IN ACTIVITIES TO PROMOTE AND IMPROVE THE OVERALL HEALTH OF, AND MEET THE MEDICAL CARE NEEDS OF THE COMMUNITY.

Activities or mission (Part I)

THE MISSION OF SAMARITAN MEDICAL PRACTICE, P.C. IS TO SUPPORT THE CHARITABLE PURPOSES OF SAMARITAN MEDICAL CENTER WHICH INCLUDES PROVIDING PHYSICIAN SERVICES DESIGNED TO IMPROVE THE STANDARDS AND QUALITY OF HEALTH CARE AVAILABLE TO THE RESIDENTS OF JEFFERSON COUNTY AND OTHER AREAS SERVED BY THE HOSPITAL. FURTHERMORE, OUR PURPOSE IS TO PARTICIPATE IN ACTIVITIES TO PROMOTE AND IMPROVE THE OVERALL HEALTH OF, AND MEET THE MEDICAL CARE NEEDS OF THE COMMUNITY.

  • PROVIDED PROFESSIONAL PHYSICIAN SERVICES IN MEDICAL SPECIALTY AREAS, SUCH AS GENERAL SURGERY, VASCULAR SURGERY, OTOLARYNGOLOGY, PULMONOLOGY, PLASTIC/COSMETIC, ORTHOPEDIC SURGERY, AND BREAST SURGERY. A TOTAL OF 41,105 TREATMENTS TO PATIENTS WERE PERFORMED.

    Expenses $17,948,102 · Revenue $7,036,756

As filed on the 2022 return. The filer continues this part on Schedule O, which is not shown here.

Listed in Part VII

  • Mario Victoria MD

    PRESIDENT/DIRECTOR

    Total calculated
    $469,280
    From this org
    $0
    From related orgs
    $422,560
    Other
    $46,720
    Hours/week
    1 + 41 related

    Schedule J breakdown matched by us

    Base
    $0 + $402,438 related
    Bonus
    $0
    Other
    $0 + $20,122 related
    Deferred
    $0 + $17,300 related
    Nontaxable benefits
    $0 + $29,420 related
    Filer's total
    $0 + $469,280 related

  • Thomas H Carman

    CEO OF SMC/SECRETARY

    Total calculated
    $938,040
    From this org
    $0
    From related orgs
    $880,166
    Other
    $57,874
    Hours/week
    1 + 43.5 related

    Schedule J breakdown matched by us

    Base
    $0 + $699,733 related
    Bonus
    $0 + $174,933 related
    Other
    $0 + $5,500 related
    Deferred
    $0 + $11,200 related
    Nontaxable benefits
    $0 + $46,674 related
    Filer's total
    $0 + $938,040 related

  • Maxine Briggs

    CFO OF SMC/TREASURER

    Total calculated
    $499,877
    From this org
    $0
    From related orgs
    $453,847
    Other
    $46,030
    Hours/week
    1 + 42.5 related

    Schedule J breakdown matched by us

    Base
    $0 + $433,347 related
    Bonus
    $0
    Other
    $0 + $20,500 related
    Deferred
    $0 + $17,300 related
    Nontaxable benefits
    $0 + $28,730 related
    Filer's total
    $0 + $499,877 related

  • Tony Chuang

    OTOLARYNGOLOGIST

    Total calculated
    $635,512
    From this org
    $611,674
    From related orgs
    $0
    Other
    $23,838
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $551,574
    Bonus
    $60,100
    Other
    $0
    Deferred
    $17,300
    Nontaxable benefits
    $6,538
    Filer's total
    $635,512

  • David Newman

    GENERAL SURGEON

    Total calculated
    $629,540
    From this org
    $604,309
    From related orgs
    $0
    Other
    $25,231
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $602,309
    Bonus
    $2,000
    Other
    $0
    Deferred
    $17,300
    Nontaxable benefits
    $7,931
    Filer's total
    $629,540

  • Christopher Gordon

    OTOLARYNGOLOGIST

    Total calculated
    $629,090
    From this org
    $584,203
    From related orgs
    $0
    Other
    $44,887
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $440,003
    Bonus
    $144,200
    Other
    $0
    Deferred
    $15,467
    Nontaxable benefits
    $29,420
    Filer's total
    $629,090

  • Maurice Tom-Pack

    GENERAL SURGEON

    Total calculated
    $578,764
    From this org
    $561,998
    From related orgs
    $0
    Other
    $16,766
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $559,998
    Bonus
    $2,000
    Other
    $0
    Deferred
    $8,685
    Nontaxable benefits
    $8,081
    Filer's total
    $578,764

  • Brian Zafonte

    ORTHOPEDIC SURGEON

    Total calculated
    $1,007,962
    From this org
    $990,729
    From related orgs
    $0
    Other
    $17,233
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $980,729
    Bonus
    $10,000
    Other
    $0
    Deferred
    $0
    Nontaxable benefits
    $17,233
    Filer's total
    $1,007,962

Compensation is as filed in Part VII: reportable pay from this organization and from related organizations, other compensation, and hours per week. The total, marked calculated, is our sum of the three dollar columns, with a blank column counted as $0; the form itself has no total. On a Form 990-EZ the columns are Part IV's instead, and on a Form 990-PF Part VIII's — compensation, contributions to benefit plans, and expense account — and the total sums those. A Schedule J breakdown is as filed: base pay, bonus, other, deferred compensation and nontaxable benefits from this organization, with any from related organizations beside each, and the filer's own total. It is shown with the Part VII listing of the same name on the same return. The form gives no key between the two, so that pairing is ours, and is marked matched by us.

Schedule J

Answered yes

  • 3 · Compensation committee
  • 3 · Independent compensation consultant
  • 3 · Written employment contract
  • 3 · Compensation survey or study
  • 3 · Approval by the board or compensation committee
  • 4b · Supplemental nonqualified retirement plan

Answered no

  • 4a · Severance or change-of-control payment
  • 4c · Equity-based compensation arrangement
  • 5a · Pay contingent on this organization's revenues
  • 5b · Pay contingent on a related organization's revenues
  • 6a · Pay contingent on this organization's net earnings
  • 6b · Pay contingent on a related organization's net earnings
  • 7 · Other non-fixed payments
  • 8 · Paid under the initial-contract exception

The filer's explanations (Part III)

PART I, LINE 4B
THE FOLLOWING INDIVIDUALS RECEIVED CONTRIBUTIONS TO AN IRC 457(F) PLAN DURING 2022: N/A THE FOLLOWING INDIVIDUALS RECEIVED CONTRIBUTIONS TO AN IRC 457(B) PLAN DURING 2022: MAXINE BRIGGS- $20,500 MARIO VICTORIA- $20,122

Part I's answers as filed. A line not listed was left unanswered; on lines 1a and 3 that means the box was not checked.

Grants on this return

No itemized grants to organizations on this return.

Related organizations on this return

Schedule R Part II: tax-exempt organizations related to the filer by control. It does not record shared board members or money.

Provenance

Return type
form_990
Tax year
2022
Filed
13 November 2023
IRS schema version
2022v5.0
Source object
202303189349311210

Check it against the return as filed: the GivingTuesday Data Lake hosts a public copy of the original XML.

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